australian journal of advanced nursing

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Health, as we know is a result of many factors. The social determinants of health are well documented and understood. But our health system in Australia is not one that has developed around those social determinants. Our system is medical centric, it is illness based, reactive and tertiary focused. It ignores everything we know about keeping communities healthy. Any attempts to move to the system are patchy, isolated and while usually very successful, not supported with adequate resources nor rolled out on a system scale. More than ever, in dire financial times, we need to focus on those things that keep us healthy, things like decent work, adequate housing, food, access to education and recreation, emotional support and social inclusion. Let’s ask our communities what they need rather than paternalistically handing out services. Undoubtedly the way forward is to build a decent primary health care system. But to do so needs vision and a great deal of will. Nurses can lead the way in such reform and indeed in Australia and many other parts of the world nurses are doing just that. Nurses prefer to immerse themselves into communities. We are not prone to locking ourselves in offices behind desks, giving 15 minute blocks of care. We see whole communities, families, supportive groups and beyond. I spoke to a nurse recently who works in a nurse led health care service in a regional town; a town that was struggling economically and whose people were having significant health problems including mental health deterioration. One of the main problems was the lack of an adequate sewerage system which caused, among other things, certain health problems. The nurses in the clinic successfully lobbied to get a decent sewerage system for their town. Not only did this improve health outcomes but made the town a more attractive place to live, increased the population and sustained the economy of their region! Now that is really dealing with health from a social determinant perspective. So whilst it is important that in warding off the dire consequences of the GFC we create economic stimulus packages that invest in roads, houses and schools, we must not forget about investing in health – and that doesn’t only mean simply building hospitals, far from it. It means investing in reform programs that transfer a reactive health system to a proactive one. At the moment Australia’s health system pulls us out of deep water but doesn’t stop us falling in. And right now we are teetering on the edge. Health care should be viewed as an asset not a liability. It is like a long term investment that will mature and once the returns on that investment do mature, we will as a society reap the benefits with profits untold. GUEST EDITORIAL AUSTRALIAN JOURNAL OF ADVANCED NURSING Volume 26 Number 4 5
RESEARCH PAPER Living the experience of breast cancer treatment: The younger women‘s perspective AUTHORS Elisabeth Coyne RN, RM, BN, M Nursing (Hons with Distinction) Lecturer, School of Nursing and Midwifery, Griffith University Logan Campus, Queensland, Australia. e.coyne@griffith.edu.au Sally Borbasi RN, PhD Professor of Nursing, School of Nursing and Midwifery, Griffith University Logan Campus, Queensland, Australia. s.borbasi@griffith.edu.au KEY WORDS young women, breast cancer, qualitative ABSTRACT Objective To explore the experience of breast cancer for young women under fifty years of age and describe their personal experience of coping with breast cancer treatment. Design An interpretive qualitative design was used to explore the experience of breast cancer in a young women’s life. A purposive sample of six women completed in‑depth interviews. A thematic analysis of the transcripts generated several themes relating to their personal journey through breast cancer treatment. Setting The setting for this study was an oncology outpatient’s setting in a large private hospital in Queensland, Australia. Subjects Six women aged between 28 and 45 years of age with a diagnosis of breast cancer in the last 12 months. Results Treatment for breast cancer began so quickly following diagnosis leaving little time to adjust to the concept of a life threatening disease. The severity of the effects from treatment influenced the women’s sense of person and ability to care for family. Fatigue, nausea and early onset menopausal changes were particularly troubling. Women described a positive resolve to survive. Conclusions Treatment concerns for younger women are qualitatively different from those of older women. They consider they are too young to assume ‘the sick role’ and are not prepared for its sudden onset, neither are their support networks. The right kind of support can assist younger women and their families to cope during the early stages of diagnosis and intervention. AUSTRALIAN JOURNAL OF ADVANCED NURSING Volume 26 Number 4 6
Page 1 and 2: June - August 2009 Volume 26 Number
Page 3 and 4: AJAN australian journal of advanced
Page 5: Health and the Global Financial Cri
Page 9 and 10: such as, ‘tell me how you felt wh
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Page 15 and 16: RESEARCH PAPER Verbal, physical and
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Page 19 and 20: In the study, children working on t
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Page 23 and 24: the street. The harsh conditions un
Page 25 and 26: INTRODUCTION The concept of the sho
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Page 29 and 30: REFERENCES Abenhaim, H.A., Kahn, S.
Page 31 and 32: INTRODUCTION The concept of ‘spir
Page 33 and 34: Table 1: Characteristics of partici
Page 35 and 36: Spirituality propelled people into
Page 37 and 38: Predictors of nurses’ commitment
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Page 41 and 42: facilities were around eight hundre
Page 43 and 44: positively correlated with organisa
Page 45 and 46: commitment and job satisfaction, pe
Page 47 and 48: REFERENCES Al‑Aameri, A.S. 2000.
Page 49 and 50: Wasti, S.A. 2002. Affective and con
Page 51 and 52: INTRODUCTION Monitoring quality of
Page 53 and 54: Presence of a clinical problem in a
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Limitations There were a number of
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Basic life support knowledge of und
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students enrolled in the undergradu
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different groups of health professi
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SCHOLARLY PAPER Nurse practitioners
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area health services failing to see
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close contact with a senior medical
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E-portfolios: developing nurse prac
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the candidate’s current role. Thi
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of the NP role and planning future
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Driessen, E., van der Vleuten, C.,
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INTRODUCTION Lifestyle behaviours h
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one couple thought it would not and
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Although four couples said that it
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state of mind and have suitable res
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Section 2 - Factors that may influe
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INTRODUCTION Pressure ulcers have t
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Song and Choi scale The Song and Ch
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study of a cardiac surgical unit an
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O’ Connell, B. and Myers, H. 2002
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